光比浊法评价老年心血管疾病患者阿司匹林抵抗的现患率及相关危险因素  

Prevalence of and risk factors for aspirin resistance by light transmittance aggregometry in elderly patients with cardiovascular disease

作　　者：曹剑[1] 刘霖[1] 范利[1] 胡国梁[1] 胡亦新[1] 李晓利[1] 石海燕[1] 

机构地区：[1]解放军总医院南楼心血管一科,北京100853

出　　处：《武警医学》2011年第12期1019-1023,共5页Medical Journal of the Chinese People's Armed Police Force

基　　金：军队十一五重点保健课题(07BJZ01);国家科技部支撑计划课题(2009BA186B04)

摘　　要：目的光比浊法评价老年心血管疾病患者阿司匹林抵抗的现患率及可能的潜在危险因素。方法 454例老年心血管疾病患者,平均(73.91±8.12)岁,口服阿司匹林(≥75 mg)1个月以上。结果光比浊法检测结果显示,38例(8.4%)发现为阿司匹林抵抗,166例(36.6%)为阿司匹林半抵抗,阿司匹林不敏感者(含阿司匹林抵抗和半抵抗)总计204例(45%)。多因素回归分析表明,血管紧张素转换酶抑制药/血管紧张素受体拮抗药(ACEIs/ARBs)(OR=0.638,95%CI:0.414～0.983,P=0.042)和硝酸酯类药物(OR=0.570,95%CI:0.367～0.884,P=0.012)为阿司匹林不敏感者的保护性因素。结论实验室检测提示,老年心血管疾病患者阿司匹林抵抗发生率较高,ACEIs/ARBs,硝酸酯类药物为阿司匹林不敏感者的保护性因素。Objective To evaluate the prevalence of and risk factors for aspirin resistance in elderly patients with cardiovascular disease（CVD） by light transmittance aggregometry （LTA）. Methods 454 patients（ age, 73.91 ± 8. 12 years） with CVD receiving daily aspirin therapy （ ≥75 nag） over one month were recruited. Results By LTA, 38 （8.4%） elderly patients were found to be resistant to aspirin therapy; 166 （36. 5% ） patients were semi -responders; 204（44. 9% ） patients were nonsensitive. In the multivariate logistic regression analysis, the administration of angiotensin - converting enzyme inhibitors or angiotensin receptor blockers （ACEIs/ARBs） （OR = 0. 638, 95% CI： 0. 414- 0. 983, P = 0.042）, and nitrates （OR = 0. 570, 95% CI： 0. 367- 0. 884, P = 0. 012 ） was a significant protective factor for aspirin non - sensitivity. Conclusions The prevalence of aspirin resistance in elderly patients with CVD is considerably high. The administration of ACEIs/ARBs and nitrates is a protective factor for aspirin non - sensitivity.

关 键 词：光比浊法 阿司匹林抵抗 老年患者 心血管疾病 危险因素 

分 类 号：R541[医药卫生—心血管疾病] R543[医药卫生—内科学]